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Vol. IV, No. 07 ~ EINet News Briefs ~ April 21,
2001
****A free service of the APEC Emerging Infections Network*****
The EINet listserv was created to foster discussion,
networking, and collaboration in the area of emerging infectious diseases
(EID's) among academicians, scientists, and policy makers in the AsiaPacific
region. We strongly encourage you to share their perspectives and experiences,
as your participation directly contributes to the richness of the "electronic
discussions" that occur. To respond to the listserv, use the reply function.
In this edition:
- Infectious disease information
- Notices
- Journal Articles
- How to join the EINet listserv
1. OVERVIEW OF INFECTIOUSDISEASE INFORMATION
Below is a bimonthly summary of AsiaPacific emerging infectious diseases.
ASIA
CHINA (HAINAN) DISTINCT CHOLERA STRAIN
A distinct strain of Vibrio cholerae was isolated from a septicemic
patient in Hainan Province. Phenotype, DNA, and serological testing
have identified the strain as V. cholerae 013 group. Research
and testing suggest that this strain has not been identified previously
in either China or abroad. According to the Medical Information Institute
of the Chinese Academy of Medicine, this is the first time that a non㪙
group V. Cholerae has been isolated from a septicemic patient
in China. It is not currently known how many patients may be infected,
but the septicemic patient died three days following admission to the
hospital. Assays indicate that the strain is very toxic in mice, and
that it is sensitive to a number of antibiotics. The strain is currently
being preserved at the Chinese Microbiological Culture Preservation
Center.
[PROMED 4/18/01]
JAPAN (TOKYO) E. COLI OUTBREAK
The Japanese Ministry of Health, Labor, and Welfare announced that 264
patients had tested positive for E. coli 0157, among whom 76
were asymptomatic. Of the 264 patients, 178 had eaten contaminated meat.
Bacteria isolates from 130 patients showed identical DNA patterns. Affected
areas in Japan include Chiba, Saitama, Tokyo, Kanagawa, Gunma, Ibaragi,
and Yamagata.
[PROMED 4/17/01]
VIETNAM HIV CASES FEWER THAN PREDICTED
According to Vietnams Health Minister, Do Nguyen Phuong, the total
number of HIV/AIDS patients in Vietnam is about oneeighth of that predicted
in 1996 for the year 2000. While the total number of HIV/AIDS cases
is estimated to be about 35,899, some estimates had predicted that figure
to reach 287,600 by the end of 2000. Phuong attributed the current infection
rates to increased awareness as a result of nationwide
prevention efforts. He also stated that the number of HIV/AIDS patients
with access to medical care increased from 10 percent in 1995 to 65
percent in 1999. According to Phuong, three major prevention programs
to be launched over the next five years will focus on minimizing the
spread of HIV in communities throughout the country, delaying the progression
from HIV to AIDS, and minimizing the impact of the disease on socioeconomic
development.
[VIETNAM NEWS 4/7/01, http://vietnamnews.vnagency.com.vn]
AMERICAS
USA OUTBREAK OF ACUTE RESPIRATORY ILLNESS IN COLLEGE STUDENTS
As of April 9, 221 college students from 37 colleges in 18 states
are reported to have been infected with an acute respiratory febrile
illness following travel to Acapulco, Mexico, during March. Ten
students in six states have been hospitalized. The CDC was first
informed of this outbreak by the Pennsylvania Department of Health
when 44 students from two colleges became ill with symptoms that
included high fever, headache, dry cough, and chills, within 7 to
14 days of their return. Most of the ill students stayed at the
Calinda Beach Hotel in Acapulco. Preliminary laboratory test results
suggest histoplasmosis, an infection caused by Histoplasma capsulatum,
a fungus that resides in soil in areas where the disease is endemic.
The CDC recommends that students who have traveled to Acapulco since
March 1 seek medical care if they experience symptoms of fever and/or
cough, shortness of breath, chest pain, or headache.
[MMWR 50;2001:261𤫶,
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5014a1.htm]
2. NOTICES
20th APEC ISTWG MEETING VIETNAM
The 20th meeting of the APEC Industrial Science and Technology Working
Group (ISTWG) scheduled for April 23rd27th in Hanoi, Vietnam will
include a side meeting on Health/Emerging Infections on Tuesday, April
24 at the Melia Hanoi Hotel. The agenda for the side meeting will focus
on APEC emerging infectious disease (EID) projects and proposals, strategy
development, including ways in which APEC can
provide added value to global efforts, and continuing the electronic dialogue.
MEAT PLANT RECALLS MEAT AND TURKEY PRODUCTS
BarS Foods Co. is voluntarily recalling approximately 14.5 million pounds
of readytoeat meat and poultry products that may be contaminated with
Listeria monocytogenes. These products include luncheon meats,
whole hams, sausages, hot dogs, corn dogs and various others produced
at the Clinton, Oklahoma facility. The products were distributed to retail
stores, delis, and institutions throughout the U.S. as well as in Japan,
Korea, Mexico, Puerto Rico, and the South Pacific. The Clinton plant has
been voluntarily closed since March 29, 2001 after the Food Safety and
Inspection Service (FSIS) discovered the bacteria in a sample of sliced
ham produced at the plant.
Consumption of contaminated food products can cause listeriosis, an uncommon
but potentially fatal disease. While healthy people do not generally develop
the disease, pregnant women, infants, the elderly, and those with weak
immune systems are at increased risk
[FSIS PRESS RELEASE 4/12/01, http://www.fsis.usda.gov/OA/recalls/prelease/pr021.htm]
UN TO LEAD FIGHT AGAINST HIV/AIDS
Koffi Annan, the Secretary General of the United Nations, Gro Harlem Brundtland,
DirectorGeneral of the World Health Organization (WHO), and Peter Piot,
Executive Director of the Joint UN Programme on HIV/AIDS, met with CEOs
and senior executives of six pharmaceutical companies to discuss measures
to improve access to better healthcare, HIV medicines, and HIVrelated
medicines for developing countries.
The Secretary General urged the pharmaceutical companies to continue efforts
to make drugs more affordable while also underscoring the need for active
participation of all partners in the fight against AIDS, calling for increased
political will and significant additional funding. The UN has convened
a Special Session of the General Assembly on HIV/AIDS to focus on intensifying
international action and marshalling needed resources
to combat the spread of HIV/AIDS. The session will be held from June 25㪳
in New York. For more information, visit the following URL:
http://www.unaids.org/whatsnew/press/eng/pressarc01/amsterdam_050401.html.
UNSTERILIZED EQUIPMENT FUELS SPREAD OF HIV, HCV, HBV IN DEVELOPING
COUNTRIES
Recent WHO figures estimate that approximately 12 billion injections are
administered globally each year, of which only 10 percent are for immunizations,
and 75 percent are estimated to be unnecessary. According to Dr. Keith
M. Sabin, an epidemiologist with the Division of HIV/AIDS Prevention at
the CDC in Atlanta, this large number of unnecessary injections is contributing
to the spread of bloodborne pathogens, such as HIV, hepatitis C virus
(HCV), and hepatitis B virus (HBV), due to the reuse of nonsterile injection
equipment. Dr. Sabin estimates that approximately 80 percent of injections
in southeast Asia, just under 80 percent in Africa, and nearly 70 percent
in Eastern Europe involve the use of nonsterilized equipment. 1998 WHO
figures estimate that cases of chronic infection with HIV, HCV, and HBV
in Africa were 22.7 per million,
22.5 per million, and 59.3 per million, respectively. Similarly, figures
for Asia were 7.3 per million, 107.5 per million, and 286.8 per million
for HIV, HCV, and HBV, respectively. In turn, high prevalence rates increase
the chances that these infections are transmitted through the use of nonsterile
injection equipment.
[REUTERS/MEDSCAPE 4/5/01, http://www.medscape.com]
FAO, WHO REQUEST FOR CAMPYLOBACTER RISK ASSESSEMENT
INFORMATION
The Food and Agriculture Organization (FAO) and WHO have recently initiated
work on risk assessment of Campylobacter spp. in broilers (chickens
raised for broiling). During a meeting at the FAO headquarters in Rome
in March 2001, a number of areas were identified where data are needed
to address the issue of risk. The FAO and WHO are issuing a second call
for data relevant to risk assessment of Campylobacter in broilers.
Specifically, the key data requirements include: Exposure assessment (onfarm,
processing, preparation, and consumption) and hazard characterization.
Please submit risk assessments and the relevant information no later than
May 1 to lourdes.costarrica@fao.org
or toyofukuh@who.int. You may also
view additional information on the web at either http://www.fao.org/ES/ESN/pagerisk/camp2.htm
or
http://www.who.int/fsf/mbriskassess/index.htm.
3. JOURNAL ARTICLES
TRANSMISSION OF BSE AND vCJD IN A PRIMATE MODEL
Researchers in France have shown that bovine spongiform encephalopathy
(BSE) can be transmitted from primate to primate intravenously. Dr. Corinne
Ida Lasmezas and colleagues in France used a macaque model to determine
to what extent the BSE/vCJD agent is pathogenic to humans by intracerebral
and intravenous routes. In this study, the researchers first infected
macaques intracerebrally with concentrated samples of the BSE
and vCJD agents obtained from infected cattle and humans, respectively.
Samples from the BSEinfected macaques were then injected either intracerebrally
or intravenously to healthy macaques. All of the macaques injected with
the infectious agent developed the disease. The researchers found that
transmission of the vCJD/macaqueBSE agent resulted in a more virulent
form of the disease than did the BSE agent from cattle,
suggesting an adaptation of the BSE agent to primates. The intravenous
route was also shown to be very efficient for secondary transmission of
BSE. The authors caution that the results do not prove that vCJD can be
passed to humans through the blood supply; it is not currently known whether
the concentration of the infectious agent is adequate to transmit the
infection. Nonetheless, the authors contend that their findings further
support the need for enhanced global CJD surveillance efforts.
[PROC NATL ACAD SCI USA 2001;98:4142]
DISTINCT VARIANT OF VANCOMYCINRESISTANT E. FAECIUM ASSOCIATED WITH
HOSPITAL EPIDEMICS
A recent study shows that a distinct subpopulation of vancomycinresistant
Enterococcus faecium (VREF) has been associated with hospital outbreaks
in various countries. Dr. Rob J. L. Willems, from the National Institute
of Public Health and the Environment in the Netherlands, and colleagues
genotyped 120 VREF isolates associated with hospital outbreaks and 45
nonepidemicassociated isolates from the United States, Europe, and Australia.
From this genotyping, the researchers identified a genetically related
epidemic VREF genogroup that was associated with hospital outbreaks in
all three continents and genetically distinct from the nonepidemic isolates.
In addition, the esp virulence gene, which has been associated with increased
virulence in E. faecalis, was present in 15 of the 16 epidemic
clones tested but not in any of the 29 nonepidemic isolates tested. This
gene was also absent from all 98 VREF isolates from Dutch animals. The
authors suggest that screening for the presence of the variant esp gene
or the specific purK allele, which was identical in 36 of 38 epidemic
isolates examined, could serve as a useful marker for controlling such
infections.
[LANCET 2001;357:858𤵇]
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Further information about the APEC Emerging Infections Network is available
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